Nothing but the Tooth column: Could be time to find another dentist

Dr. Richard Greenberg
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Q: I’m hoping for some advice. I have a molar that has been falling out since October. The back molar prepared temp fell out after three days. A crown was put in two weeks later, and it fell out after three days. Each time I ate soft food. It was built with bond that fell off in three days. The special bonding filling fell off in three days. I paid $650 for half of a crown. Insurance won’t pay any more. I am on a fixed income, retired, age 72. Help.

- E. Jane

A: I do have advice and it is going to be rather strong and direct.

Unless you have a specific reason to not follow what I am about to say, I would ask for your deposit back and LEAVE THE DENTIST. (If you do, take your records and any films with you for the new dentist. Those records and films legally belong to you).

The reason I am so blunt is that the retention of a crown is something that any competent dentist can control. I say this for the following reasons:

Usually, if your remaining tooth structure is very short, retention of a crown can be difficult. But all it takes is more time on the part of the dentist to build up that short bit of remaining tooth structure with a variety of materials available. It is called a “core buildup.” It might be more costly, but if needed, then the cost is justified. There are times when a core buildup requires doing root canal treatment first, but those times are rare. Sometimes even using a more retentive cement will help, but this is not as good as the other choices. Cement does not retain a cap or crown, the design does. That is within the dentist’s control.

Now, it is possible that since the dentist has already spent a lot of time (albeit failures of time), he/she might object to giving you back your deposit. If that does happen, then your only choice is to follow through to the final restoration and if that fails (falls off), then you would ask for the entire amount of money reimbursed.

If the dentist objects, I would write a letter to your state health department explaining what has happened. I believe all states have a way to deal with this type of claim. Either they have a peer (other dentists) review group or they have a judicially oriented group that can force the dentist to do the right thing if he/she is unwilling. Indeed, the dentist could lose their state license over a problem like this.

You could show the dentist my letter if you like or just discuss with the dentist what your thoughts are after reading my letter. I do not like to be so harshly direct but I am upset, in general, for how dentistry is practiced in this day and age. That is essentially why I do this column. Good questions deserve good answers.

Dr. Richard Greenberg of Ipswich practiced dentistry for 45 years after having attended dental school at Columbia University, where he was later an associate clinical professor of restorative dentistry and facilitator of the course of ethics. Do you have a dental question or comment about the column? Email him at dr.richard@nothingbutthetooth.org.